Doctors have identified the mystery illness that has made a little Filipino girl critically ill for the past two months.
Three-year-old Caitlin Soleil Lucas arrived in Singapore two weeks ago in the hope of getting a clear diagnosis for a series of life-threatening symptoms after doctors in the Philippines were unable to help her.
On Friday, experts at the National University Hospital (NUH) confirmed that she has juvenile myelomonocytic leukaemia (JMML), a rare and serious condition that occurs in about 1.2 cases in a million. Mostly afflicting young children, it is caused by an overproduction of immature white blood cells in the bone marrow.
A team of doctors are currently in discussion with the family on how to treat Caitlin.
"Now that we finally have an answer, we know what we're fighting against," said her 34-year-old father and wedding photographer Jericho Jose Lucas.
About juvenile myelomonocytic leukaemia
It is a rare childhood cancer in which too many immature white blood cells are produced. Symptoms include skin rashes, bruising, high white blood cell count, low red blood cell and platelet counts, swollen lymph nodes, and an enlarged liver and spleen.
However, the condition is often difficult to diagnose as it may share similar features with infectious diseases.
Due to the rarity of the condition, a consensus on its treatment remains unclear, though it may involve a bone marrow transplant or chemotherapy.
Medical studies have found that around half of those who undergo a bone marrow transplant obtain long-term remission, though a significant number may relapse within a few months.
"We're relieved. It's been a long wait for this since Caitlin was first hospitalised more than two months ago."
Her illness first surfaced last September as insect bites on her right ankle, said her 30-year-old mother, fashion stylist Christine Del Feliz Lucas. They quickly developed into skin lesions, which spread across her legs, arms and face.
Although the lesions eventually faded, an onslaught of other symptoms appeared, including severe abdominal pain, an enlarged spleen and liver, low platelet and red blood cell counts and chronic diarrhoea.
Since she was first hospitalised on New Year's Day, Caitlin has undergone a series of procedures - from bone marrow aspirations to blood tests - as doctors worked to diagnose her illness.
On Feb 25, she had to be warded in NUH's paediatric intensive care unit after doctors found a bacterial infection in her gut. She has since been transferred back to a regular ward, and is due to be discharged today once she has completed her 10-day antibiotics course.
Her parents are intending to stay here for Caitlin to be treated for JMML, which she will be able to do as an outpatient. "Since coming to Singapore, she has been feeling better each day. Her appetite is back, and she is alert and chatty. She also loves to paint, so she has been doing that a lot," said Mr Lucas.
On Thursday, Caitlin was granted an afternoon away from the hospital. An animal lover, she asked her parents to take her to the Singapore Zoo.
Seeing the elephants and giraffes, two of her favourite animals, made her eyes light up, said her father.
"We had fond memories of our visit to the zoo last year while we were on a holiday in Singapore, so she was very excited to see the animals again," he said.
"Now, we hope to take her to the aquarium because she wants to see the fishes."